Can Jaw Angle Implants Break From Boxing?

Q: Dr. Eppley, I had jaw angle surgery and it was over-resected. I want to reconstruct my jaw angle (vertical height) and widen my front chin .  I have a before and after x-rays of my mandible and I want to have it reconstructed as before. Also I want to get rid of my titanium screws. I enjoy boxing and i am really worried about this reconstructing surgery.  

1) Can silicone be broken or bent or destroyed by punches?

2) Can silicone be moved or migrated by punches? Even if I get a 3D customized fit and screws attached? ( I’ve heard that it happens quite often)  

You told me before that silicone would never move no matter how hard it is traumatized  and I can enjoy every sport. However I’ve seen many cases of silicone implants moving. If your word is true please explain me how does that work.

A: While I don’t know where you are getting your information about jaw angle implants, I can only tell you what I know based on my experience answering questions and treating patients from all over the world in the past two decades with this type of facial implant surgery. I have yet to have an actual patient or an inquiry where someone has had jaw angle implant displacement from trauma. Perhaps this has happened to someone in the world, but I have yet to ever hear about it or treat anyone for it.

The apparent negligible incidence of silicone jaw angle implant displacement can be explained by an understanding of its biomaterial composition and the biology of encapsulation around it. The solid silicone elastomer of facial implants can not be fractured or broken, regardless of the imposing force, because it is not a brittle material.  You can take a hammer to a facial implant and you simply cannot break into pieces. The bonds between the silicone molecules are flexible nor rigid. Thus when I say putting a silicone implant against a facial bone acts like a bumper, that is because of what it actually does and behaves like.

The long-term stability of any facial implant is ultimately determined by the body creating a layer of scar around it, a process known as encapsulation. This capsule (layer of scar) is what holds the implant in place and preventing future migration or displacement. The purpose of screw fixation of facial implants is to hold the smooth surfaced material securely in place until this enveloping scar tissue forms. For most patients, the screws beyond this point (6 weeks or so after surgery) have little value. But in the patient who may be exposed to some periodic facial trauma (e.g., boxing), the screws add extra insurance against any potential risk of implant displacement

Dr. Barry Eppley

Indianapolis, Indiana